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Advanced Ultrasound in Diagnosis and Therapy ›› 2022, Vol. 6 ›› Issue (3): 104-111.doi: 10.37015/AUDT.2021.210019

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  • 收稿日期:2022-06-14 修回日期:2022-07-04 出版日期:2022-09-30 发布日期:2022-08-08

Contrast-enhanced Ultrasound for Evaluation of Active Needle Tract Bleeding during Thermal Ablation of Liver Cancer

Huolin Ye, MDa, Qiannan Huang, MDa, Qingjing Zeng, MDa, Xuqi He, MDa, Erjiao Xu, MDa,b, Yinglin Long, MDa, Kai Li, MDa, Rongqin Zheng, MDa,*()   

  1. a Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
    b Department of Ultrasound, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
  • Received:2022-06-14 Revised:2022-07-04 Online:2022-09-30 Published:2022-08-08
  • Contact: Rongqin Zheng, MD E-mail:zhengrq@mail.sysu.edu.cn

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Abstract:

Objective: To investigate the accuracy of contrast-enhanced ultrasound (CEUS) in the diagnosis and localization of active needle-tract bleeding (ANTB) during thermal ablation for liver cancer.

Methods: Between June 2013 and December 2018, liver cancer patients with poor coagulation function or suspected needle-tract bleeding during ablation were enrolled in the study. Conventional US and CEUS were applied to detect ANTB and the bleeding sites, and sequentially abdominal paracentesis drainage (APD) was used as the gold standard for the diagnosis of ANTB. Thermal ablation guided by conventional US or CEUS was used to stop the bleeding.

Results: Among the 77 enrolled patients, 21 patients (27.3%, 21/77) had ANTB. In total, four (19.0%) and 21 (100%) cases of ANTB were diagnosed by colour Doppler US and CEUS, respectively. The sensitivity, specificity and accuracy of colour Doppler US for diagnosing ANTB were 19.0%, 100% and 77.6%, respectively. The sensitivity, specificity, and accuracy of CEUS for diagnosing ANTB were 100%, 100% and 100%, respectively. The sensitivity of CEUS to diagnose ANTB was significantly higher than that of colour Doppler US (P < 0.001). All cases of ANTB were arterial bleeding and were stopped by thermal ablation under the guidance of colour Doppler US or CEUS.

Conclusion: Compared to colour Doppler US, CEUS could detect ANTB with significantly higher sensitivity and accurately guide needle-tract ablation during thermal ablation of liver cancer.

Key words: Contrast-enhanced ultrasound, Ablation techniques, Liver cancer, Haemorrhage

[1] Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin 2011; 61:69-90.
[2] Bray F, Ferlay J, Soerjomataram I, Siegel R, Torre L, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68: 394-424.
[3] Marrero JA, Kulik LM, Sirlin CB, Zhu AX, Finn RS, Abecassis MM, et al. Diagnosis, staging, and management of hepatocellular carcinoma: 2018 practice guidance by the american association for the study of liver diseases. Hepatology 2018; 68; 723-750.
[4] European association for the study of the liver, European organisation for research and treatment of cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. Eur J Cancer 2012; 48: 599-641.
[5] Arii S, Yamaoka Y, Futagawa S, Inoue K, Kobayashi K, Kojiro M, et al. Results of surgical and nonsurgical treatment for small-sized hepatocellular carcinomas: a retrospective and nationwide survey in Japan. The Liver Cancer Study Group of Japan. Hepatology 2000; 32: 1224-1229.
[6] Lau WY, Lai EC. The current role of radiofrequency ablation in the management of hepatocellular carcinoma. A systematic review. Ann Surg 2009; 249: 20-25.
[7] Shiina S, Teratani T, Obi S, Hamamura K, Koike Y, Omata M. Nonsurgical treatment of hepatocellular carcinoma: from percutaneous ethanol injection therapy and percutaneous microwave coagulation therapy to radiofrequency ablation. Oncology 2002; 62 Suppl 1:64-68.
[8] Fonseca AZ, Santin S, Gomes LG, Waisberg J, Ribeiro MAF Jr. Complications of radiofrequency ablation of hepatic tumors: frequency and risk factors. World J Hepatol 2014; 6: 107-113.
[9] Bertot LC, Sato M, Tateishi R, Yoshida H, Koike K. Mortality and complication rates of percutaneous ablative techniques for the treatment of liver tumors: a systematic review. Eur Radiol 2011; 21: 2584-2596.
[10] Goto E, Tateishi R, Shiina S, Masuzaki R, Enooku K, Sato T, et al. Hemorrhagic complications of percutaneous radiofrequency ablation for liver tumors. J Clin Gastroenterol 2010; 44: 374-380.
[11] Carrafiello G, Laganà D, Ianniello A, Craparo G, Recaldini C, Lumia D, et al. Bleeding after percutaneous radiofrequency ablation: Successful treatment with transcatheter embolization. Eur J Radiol 2007; 61: 351-355.
[12] Du J, Wang L, Wan CF, Hua J, Fang H, Chen J, et al. Differentiating benign from malignant solid breast lesions: Combined utility of conventional ultrasound and contrast-enhanced ultrasound in comparison with magnetic resonance imaging. Eur J Radiol 2012; 81, 3890-3899.
[13] Lv F, Tang J, Luo Y, Li Z, Meng X, Zhu Z, et al. Contrast-enhanced ultrasound imaging of active bleeding associated with hepatic and splenic trauma. Radiol Med 2011; 116: 1076-1082.
[14] Glaser K, Tschmelitsch J, Klingler P, Wetscher G, Bodner E. Ultrasonography in the management of blunt abdominal and thoracic trauma. Arch Surg 1994; 129: 743-747.
[15] Kearney PA Jr, Vahey T, Burney RE, Glazer G. Computed tomography and diagnostic peritoneal lavage in blunt abdominal trauma. Their combined role. Arch Surg 1989 Mar; 124: 344-347.
[16] Kim YJ, Lee MW, Park HS. Small hepatocellular carcinomas: ultrasonography-guided percutaneous radiofrequency ablation. Abdom Imaging 2013; 38: 98-111.
[17] Mulier S, Ni Y, Jamart J, Ruers T, Marchal G, Michel L. Local recurrence after hepatic radiofrequency coagulation: multivariate meta-analysis and review of contributing factors. Ann Surg 2005; 242: 158-171.
[18] Helling TS, Wilson J, Augustosky K. The utility of focused abdominal ultrasound in blunt abdominal trauma: a reappraisal. Am J Surg 2007; 194: 728-733.
[19] Beck-Razi N, Fischer D, Michaelson M, Engel A, Gaitini D. The utility of focused assessment with sonography for trauma as a triage tool in multiple-casualty incidents during the second Lebanon war. J Ultrasound Med 2007; 26: 1149-1156.
[20] Liu JB, Merton DA, Goldberg BB, Rawool NM, Shi WT, Forsberg F. Contrast-enhanced two-and three-dimensional sonography for evaluation of intra-abdominal hemorrhage. J Ultrasound Med 2002; 21: 161-169.
[21] Valentino M, Serra C, Zironi G, Luca De C, Pavlica P, Barozzi L. Blunt abdominal trauma: emergency contrast-enhanced sonography for detection of solid organ injuries. AJR Am J Roentgenol 2006; 186: 1361-1367.
[22] Catalano O, Cusati B, Nunziata A, Siani A. Active abdominal bleeding: contrast-enhanced sonography. Abdom Imaging. 2006; 31:9-16.
[23] Goldberg BB, Merton DA, Liu JB, Forsberg F. Evaluation of bleeding sites with a tissue-specific sonographic contrast agent: preliminary experiences in an animal model. J Ultrasound Med 1998; 17: 609-616.
[24] Zhou L, Kuang M, Xu Z, Xie XY, Lu MD. Contrast-enhanced sonographically guided thermal ablation for treatment of solid-organ hemorrhage: preliminary clinical results. J Ultrasound Med 2015; 34: 907-915.
[25] Kim Y, Lim HK, Rhim H, Lee MW, Choi D, Lee WJ, et al. Ten-year outcomes of percutaneous radiofrequency ablation as first-line therapy of early hepatocellular carcinoma: analysis of prognostic factors. J Hepatol 2013; 58:89-97.
[26] Rossi S, Ravetta V, Rosa L, Ghittoni G, Viera FT, Garbagnati F, et al. Repeated radiofrequency ablation for management of patients with cirrhosis with small hepatocellular carcinomas: a long-term cohort study. Hepatology 2011; 53:136-147.
[27] Kitchin DR, del Rio AM, Woods M, Ludeman L, Hinshaw JL. Percutaneous liver biopsy and revised coagulation guidelines: a 9-year experience. Abdom Radiol 2017; 43: 1494-1501.
[28] Strobel D, Seitz K, Blank W, Schuler A, Dietrich C, Herbay A von, et al. Contrast-enhanced ultrasound for the characterization of focal Liver lesions - diagnostic accuracy in clinical practice (DEGUM multicenter trial). Ultraschall Med 2008; 29: 499-505.
[29] Afaq A, Harvey C, Aldin Z, Leen E, Cosgrove D. Contrast-enhanced ultrasound in abdominal trauma. Eur J Emerg Med 2012; 19: 140-145.
[30] Catalano O, Cusati B, Nunziata A, Siani A. Active abdominal bleeding: contrast-enhanced sonography. Abdom Imaging 2006; 31: 9-16.
[31] Rhim H, Lim HK, Kim YS, Choi D. Percutaneous radiofrequency ablation with artificial ascites for hepatocellular carcinoma in the hepatic dome: initial experience. AJR Am J Roentgenol 2008; 190: 91-98.
[32] Song HP, Yu M, Zhang J, Han ZH, Su HL, Ren XL. Hemostasis of active bleeding from the liver with percutaneous microwave coagulation therapy under contrast-enhanced ultrasonographic guidance: an experimental study. J Ultrasound Med 2008; 27: 867-874.
[33] Huang Q, Xu E, Tan L, Zeng Q, Zheng R, Li K. Thermal ablation of hepatocellular carcinoma in patients with abnormal coagulation function. Int J Hyperthermia 2018; 34: 1038-1043.
[34] Claudon M, Dietrich CF, Choi BI, Cosgrove DO, Kudo M, Nolsøe CP, et al. Guidelines and good clinical practice recommendations for Contrast Enhanced Ultrasound (CEUS) in the liver- update 2012: A WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS. Ultrasound Med Biol 2013; 39: 187-210.
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